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they disclose that partner pharmacies test for stability (and therefore efficacy) under moderate temperatures during shipping

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Storage and Stability Keep lyophilised MOTS-c refrigerated (28C) After reconstitution, store in the fridge and use within 2128 days (depending on manufacturer instructions) Safety and Side Effects of MOTS-c Peptide Dosing MOTS-c is generally well-tolerated at recommended doses, but potential side effects include: Mild irritation at the injection site Headache or dizziness (rare) Nausea or gastrointestinal discomfort No long-term adverse effects have been reported in clinical trials at typical doses, but research is still limited